Graves V B, Strother C M, Partington C R, Rappe A
Department of Radiology, University of Wisconsin, Madison 53792.
AJNR Am J Neuroradiol. 1992 Jan-Feb;13(1):189-96.
To investigate the hemodynamic characteristics of lateral carotid artery aneurysms in a canine model and to determine their influence on coils and balloons.
Forty aneurysms were created in fourteen dogs and their hemodynamic characteristics and influence on coils and balloons were evaluated with angiography and color Doppler pre- and postplacement. Twenty aneurysms were treated with coils, eight with balloons, and 12 aneurysms served as controls.
The aneurysms demonstrated three distinct zones of flow: 1) an inflow zone entering at the distal aspect of the aneurysm ostium, 2) an outflow zone exiting at the proximal ostium, and 3) a central slow flow vortex. The inflow zone is a determining factor in the placement and stability of coils and balloons placed within the aneurysm and in the thrombosis of an aneurysm. The force of the inflow is considerable and can alter the shape of coils and displace both coils and balloons positioned within the aneurysm.
Coils and balloons need to be of shapes and sizes that do not conform to the inflow and outflow zones. Filling the aneurysm and blocking or displacing the inflow zone can produce thrombosis of an aneurysm with preservation of the parent artery.
在犬模型中研究颈外动脉动脉瘤的血流动力学特征,并确定其对弹簧圈和球囊的影响。
在14只犬身上制造了40个动脉瘤,通过血管造影以及放置弹簧圈和球囊前后的彩色多普勒评估其血流动力学特征以及对弹簧圈和球囊的影响。20个动脉瘤用弹簧圈治疗,8个用球囊治疗,12个动脉瘤作为对照。
动脉瘤表现出三个不同的血流区域:1)在动脉瘤开口远端进入的流入区;2)在近端开口处流出的流出区;3)中央缓慢血流涡流。流入区是放置在动脉瘤内的弹簧圈和球囊的放置及稳定性以及动脉瘤血栓形成的决定因素。流入力相当大,可改变弹簧圈的形状,并使位于动脉瘤内的弹簧圈和球囊移位。
弹簧圈和球囊的形状和尺寸应与流入区和流出区不相适应。填充动脉瘤并阻塞或移位流入区可导致动脉瘤血栓形成,同时保留载瘤动脉。